174984 07/22/2009 CITY OF CARMEL, INDIANA VENDOR: 354612 Page 1 of 1
ONE CIVIC SQUARE LAWSON FLOORING CHECK AMOUNT: $199.49
CARMEL, INDIANA 46032 2689 PAYSPHERE CIRCLE
CHICAGO IL 60674 CHECK NUMBER: 174984
CHECK DATE: 7/22/2009
DEPART AC PO NUMBER IN NUMBER AMOUNT DESCRIPTION
651 5023990 8231586 199.49 MATERIALS SUPPLIES
r. J
ORIGINAL INVOICE
0
0 eAWSON Products
Des Plaines, IL Corporate Headquarters
Addison, IL Charlotte, NO Dallas, TX Fairfield, NJ
Reno, NV •Suwanee, GA* Vernon Hills, IL Mississauga, ONT
www.lawsonproducts.com PAGE 1 MRL386
CITY OF CARMEL
SHIPPED AC 0 T NO. VOICE N0. IN ICE DATE
T''I WATER WASTEWATER 0297 92487 231586 7/02 2009 CARMEL 001
9609 HAZEL DELL PKWY
INDIANAPOLIS 46280
ET �j
CITY OF CARME L 2689 f'AYSPIEtE C IRCI E
SOLD
TO WATER- WASTEWATER CHICAGO [L ..bo674
760 3RD AVE SW STE 110
CARMEL IN 46032 DUNS NO. 00- 543 -8890 0101
FED I.D. #36- 2229304
GSA GS- 06F -0027L
$ANAEER CUSTOMER ORDER N0. /BUYERS NAME $A £$S AGENT aA7E:$NiPpED' OUE1aiADEEEi:NO; 111
llPSG':' JEFF COOPER IRYAN W01. 0 ::E32 200 MRL 8b
3�fIPT#Ca N
Pi3ECE;:.......ICdI:.: #1 #?EB:::::
:c
BUYER:JEFF COOPER
83841 GASKET REMOVER 6. EA 12 12 77.28
17054 MAINT PAINT HI -SLD PIGMT 8.74 EA 12 12 104.88
DE 6V29 'LAWSON CATALOG N/C 1 1 N/C
FRT. CHRGS. 17.33
CAS DISC UNT iFYOU
�S C
SALES USE O .AA Lo 0 ER
iii `i '33333 #i ::Cf:'
PAY THIS INVOICE BY
EXCLUDING CREDIT CARDS
TOTAL AMOUNT
TERMS: 1% TEN DAYS NET 30 DAYS
NIC NO CHARGE B/O BACK ORDERED C/O CANCELLED 199
Prescribed by State Board of Accounts City Form No. 201 (Rev 1995)
ACCOUNTS PAYABLE VOUCHER ,W
CITY OF CARMEL
An invoice or bill to be properly itemized must show, kind of service, where
performed, dates of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
354612
LAWSON FLOORING Purchase Order No.
2689 Paysphere Circle Terms
Chicago, IL 60674 Due Date 7/13/2009
F
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
7/13/2009 8231586 $199.49
hereby certify that the attached invoice(s), or bill(s) is (are) true and
orrect and l have audited same in accordance with IC 5- 11- 10 -1.6
Date Officer
VOUCHER 095994 WARRANT ALLOWED
Y'
354612 IN SUM OF
LAWSON FLOORING
2689 Paysphere Circle
Chicago, IL 60674
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
8231586 01- 7202 -06 $199.49
N
Voucher Total $199.49
Cost distribution ledger classification if
claim paid under vehicle highway fund